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Gut Motility Modulators Insights: A Comprehensive Overview

Explore the impact of neurotransmitters and medications on gut motility, including effects on water excretion and peristaltic reflex. Discover how opioid receptor antagonists and serotonin agonists influence motility and secretion within the gastrointestinal tract. Dive into the mechanisms of action of various drugs like METOCLOPRAMIDE and DIPHENOXYLATE in regulating gut function.

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Gut Motility Modulators Insights: A Comprehensive Overview

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  1. NA or other + 5-HT Enk + + + NANC 5HT3 5HT4 - + ACh DA - D2 Enk + - WATEREXCRETION 5HT1or2  ProximalContraction DistalRelaxation ACh - , - PERISTALTIC REFLEX

  2. Water Excretion NA orother ACh ACh + + X - Motility

  3. Don’t forget hormone actions esp. motilin, somatostatin ACh + Motility

  4. ACh DA - D2 +

  5. X ACh METOCLOPRAMIDE DA - D2 +

  6. NANC 5HT3 ACh 5HT4 - + ACh + 5-HT ProximalContraction DistalRelaxation + + PERISTALTIC REFLEX

  7. ACh 5HT4 + ACh + CISAPRIDE TEGASEROD(5HT4 agonists)

  8. ONDANSETRONALOSETRON(5HT3 antagonists) X NANC 5HT3 - ACh + 5-HT + INCREASED CONTRACTION BUT DECREASED MOTILITY!

  9. ACh Enk + - , -

  10. - NA or other 5HT1or2 + Enk  5-HT + ACh Enk + + inhibition of 5-HT mediating segmentation (not shown) - , -

  11. NA or other ACh + - 5HT1or2 +  5-HT DIPHENOXYLATE LOPERAMIDE ,

  12. - NA or other + 5HT1or2 5-HT Enk  + + + NANC 5HT3 ACh 5HT4 - + ACh - , - DA - D2 Enk + ALVIMOPAN and METHYLNALTREXONEare opioid receptor antagonists that increase motility and increase secretion The “SETRONS”are 5Ht3antagonist s that inhibit peristalsis CISAPRIDE and TEGASEROD are5Ht4 agonist s that increase motility METOCLOPRAMIDE is a DA antagonis thatacts as cholinomimeticsto increase motility DIPHENOXYLATE & LOPERAMIDE areopioids that decrease motilityand reduce secretion

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